eptifibatide


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eptifibatide

 [ep″tĭ-fib´ah-tīd]
an inhibitor of platelet aggregation used for prevention of thrombosis in patients with acute coronary syndrome or undergoing certain percutaneous coronary procedures; administered intravenously.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

eptifibatide

Integrilin

Pharmacologic class: Platelet aggregation inhibitor

Therapeutic class: Antiplatelet agent

Pregnancy risk category B

Action

Decreases platelet aggregation by binding to platelet-receptor glycoprotein, preventing binding of fibrinogen to platelets, which causes thrombus formation

Availability

Injection: 10-ml vial (2 mg/ml), 100-ml vial (0.75 mg/ml)

Indications and dosages

Acute coronary syndrome (unstable angina or non-Q-wave myocardial infarction)

Adults: 180 mcg/kg I.V. bolus over 1 to 2 minutes, followed by a continuous infusion of 2 mcg/kg/minute for up to 72 hours

Prevention of thrombosis related to percutaneous coronary intervention (PCI)

Adults: 180 mcg/kg I.V. bolus immediately before PCI, then a continuous infusion of 2 mcg/kg/minute, followed by a second 180-mcg/kg bolus 10 minutes after first bolus. Continue infusion until discharge or for up to 24 hours.

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug or its components

• Severe hypertension

• Bleeding disorders or evidence of active abnormal bleeding within previous 30 days

• Renal dialysis

• Recent cerebrovascular accident

• Recent surgery

• Current or planned administration of another parenteral Gp IIb/IIIa inhibitor

Precautions

Use cautiously in:

• renal insufficiency

• creatinine level below 2 mg/dl

• platelet count below 100,000/mm3

• elderly patients

• pregnant or breastfeeding patients

• children (safety and efficacy not established).

Administration

• Withdraw single bolus dose from 10-ml vial into syringe, and give by I.V. push over 1 to 2 minutes. Follow single I.V. bolus dose with continuous I.V. infusion given undiluted from 100-ml vial spiked with infusion set connected to infusion control device.

• Don't administer through same I.V. line as furosemide.

Adverse reactions

CNS: headache, dizziness, asthenia, syncope

CV: hypotension

GI: nausea, diarrhea, constipation

GU: hematuria

Hematologic: bleeding tendency, thrombocytopenia

Skin: flushing

Other: bleeding at femoral access site

Interactions

Drug-drug. Clopidogrel, dipyridamole, nonsteroidal anti-inflammatory drugs, oral anticoagulants, thrombolytics, ticlopidine: increased risk of bleeding Other platelet aggregation inhibitors: serious bleeding

Drug-diagnostic tests. Platelets: decreased count

Drug-herbs. Most commonly used herbs: increased anticoagulant effect of eptifibatide

Patient monitoring

• Monitor vital signs and assess cardiovascular status, especially for syncope and hypotension.

• Monitor coagulation studies, CBC, and platelet count. Watch for signs and symptoms of abnormal bleeding or bruising and hematuria.

• Check carefully for bleeding at all sites of invasive procedures, particularly femoral access site.

Patient teaching

• Tell patient drug may cause serious adverse effects but can help prevent a heart attack. Reassure him that he'll be closely monitored during therapy.

Instruct patient to immediately report fainting or abnormal bruising or bleeding.

• Teach patient safety measures to avoid bruising or bleeding.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

eptifibatide

Integrilin® Cardiology An antithrombotic GP IIb/IIIa receptor antagonist that blocks fibrinogen and von Willebrand factor from binding to the surface of activated platelets
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
[170 Pages Report] Peptide Based Cardiovascular Therapeutics Market research report categorizes the global market by Drug (Bivalirudin, Eptifibatide), By Distribution Channel (Hospital Pharmacies, Retail Pharmacies, Online Pharmacies), & By Region (North America, Latin America, Europe, Japan, APEJ, MEA)
M2 EQUITYBITES-March 7, 2019-Water Street partners with medical products company for launch of US FDA approved ready-to-use cardiovascular medicine eptifibatide
Global Banking News-March 7, 2019-Water Street partners with medical products company for launch of US FDA approved ready-to-use cardiovascular medicine eptifibatide
M2 PHARMA-March 7, 2019-Water Street partners with medical products company for launch of US FDA approved ready-to-use cardiovascular medicine eptifibatide
Baxter announced the FDA approval and launch of ready-to-use eptifibatide. Eptifibatide is a platelet aggregation inhibitor that prevents platelets-specialized blood cells-from sticking together and clotting.
Drugs targeting arterial thrombi include the antiplatelet drugs (aspirin, clopidogrel, abciximab, eptifibatide and tirofiban) and the fibrinolytics (streptokinase and alteplase).
Clinical scoring algorithms have been developed to aid in risk stratification, including the Global Registry for Acute Coronary Events (GRACE) (1), TIMI (Thrombolysis in Myocardial Infarction) risk score, (2), and PURSUIT [Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin (eptifibatide) Therapy] score (3).
Tantry, "Clopidogrel loading with eptifibatide to arrest the reactivity of platelets: results of the Clopidogrel Loading With Eptifibatide to Arrest the Reactivity of Platelets (CLEAR Platelets) study," Circulation, vol.
Gandhi, "Clinical and economic studies of eptifibatide in coronary stenting," Therapeutics and Clinical Risk Management, vol.
Eptifibatide. Eptifibatide is an antiplatelet drug belonging to the glycoprotein IIb/IIIa inhibitor class.
The Early Glycoprotein IIb/IIIa Inhibition in Non-ST-segment Elevation Acute Coronary Syndrome (EARLY ACS) trial: a randomized placebo-controlled trial evaluating the clinical benefits of early frontloaded eptifibatide in the treatment of patients with non-ST-segment elevation acute coronary syndrome: study design and rationale.